May 2010 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for May 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Amniotic Stem Cells Promising for Cardiac Regeneration

FRIDAY, May 28 (HealthDay News) -- A type of stem cell derived from amniotic membranes can differentiate into functioning cardiac muscle cells, and is therefore a promising source for cardiac regenerative medicine, according to a rodent study published in the May 28 issue of Circulation Research.

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Less Frequent Toothbrushing Linked to Heart Disease

FRIDAY, May 28 (HealthDay News) -- Poor oral hygiene is associated with a higher risk of cardiovascular disease, as well as higher concentrations of C-reactive protein and fibrinogen, according to research published online May 27 in BMJ.

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Use of Statins After Stroke Increasing Slowly

FRIDAY, May 28 (HealthDay News) -- The percentage of stroke patients given prescriptions for evidence-based statin treatment at hospital discharge has increased over time, but nearly one in five still leaves the hospital without a prescription, according to research published online May 27 in Stroke.

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Cardiac Event Biomarker Linked to Volume Overload

FRIDAY, May 28 (HealthDay News) -- Among stable hemodialysis patients, N-terminal probrain type natriuretic peptide (NTproBNP) may not be associated with cardiac dysfunction but appears to be dependent on factors associated with volume overload, and may also be elevated in those with malnutrition, according to a study published online May 27 in the Clinical Journal of the American Society of Nephrology.

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CRP, D-Dimer Levels Don't Affect Statin-Mortality Link

FRIDAY, May 28 (HealthDay News) -- In peripheral arterial disease (PAD) patients, statin use is associated with lower risk of cardiovascular disease (CVD) mortality and all-cause mortality, though this association is not influenced by baseline C-reactive protein (CRP) or D-dimer levels, according to research published in the May 1 issue of the American Journal of Cardiology.

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Depression Key Consideration in Acute Coronary Syndrome

FRIDAY, May 28 (HealthDay News) -- Health care providers should address depressive symptoms in survivors of acute coronary syndrome (ACS), especially women, whose early recovery may differ from their male counterparts, according to a prospective longitudinal study published in the May issue of Applied Nursing Research.

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More Systemic Inflammation May Mean Higher CAD Risk

FRIDAY, May 28 (HealthDay News) -- There appears to be a positive, independent and dose-dependent relation between systemic inflammatory markers, such as C-reactive protein (CRP), fibrinogen and homocysteine, and the estimated 10-year risk for coronary artery disease (CAD), according to research published in the May 1 issue of the American Journal of Cardiology.

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In Diabetes Patients at Low CVD Risk, Aspirin Not Recommended

THURSDAY, May 27 (HealthDay News) -- Low-dose aspirin for prevention of cardiovascular disease (CVD) is reasonable for adults with diabetes who are at increased CVD risk but should not be routinely recommended for those at low CVD risk, according to a combined statement from the American Diabetes Association, the American Heart Association, and the American College of Cardiology Foundation, published online May 27 in Circulation, Diabetes Care, and the Journal of the American College of Cardiology.

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Inflammatory Biomarker Linked to CHD in Type 2 Diabetes

THURSDAY, May 27 (HealthDay News) -- The newly recognized inflammatory biomarker lipoprotein-associated phospholipase A2 (Lp-PLA2) appears to be a risk factor for coronary heart disease (CHD) in people with type 2 diabetes, according to research published in the May issue of Diabetes.

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PCI Using Fractional Flow Reserve Effective at Two Years

THURSDAY, May 27 (HealthDay News) -- The use of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD) significantly reduces mortality and myocardial infarction at two years compared with standard angiography-guided PCI, according to a study published online May 26 in the Journal of the American College of Cardiology.

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Shunting Options Compared in Infant Heart Defect Procedure

WEDNESDAY, May 26 (HealthDay News) -- Use of a right ventricle-pulmonary artery (RVPA) shunt in infants undergoing the Norwood procedure results in better transplantation-free survival in the short term than use of a modified Blalock-Taussig (MBT) shunt, but the advantage fades in longer follow-up, according to a study in the May 27 issue of the New England Journal of Medicine.

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Stents, Endarterectomy Equally Effective at Preventing Stroke

WEDNESDAY, May 26 (HealthDay News) -- Carotid-artery stenting and carotid endarterectomy are equally effective in preventing stroke in the long term, according to a study published online May 26 in the New England Journal of Medicine to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.

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Laser Balloon Succeeds at Pulmonary Vein Isolation

WEDNESDAY, May 26 (HealthDay News) -- Acute pulmonary vein isolation can be achieved in pulmonary veins by using a compliant, variable diameter, visually-guided laser balloon with point-by-point ablative capability, according to research published online May 26 in Circulation: Arrhythmia and Electrophysiology.

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Hypertension Control Hits Healthy People 2010 Goal

TUESDAY, May 25 (HealthDay News) -- The proportion of hypertensive patients with control of the condition has reached a Healthy People 2010 goal, though rates of hypertension have remained unchanged during the past decade, according to research published in the May 26 issue of the Journal of the American Medical Association.

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Moderate Drinkers' Health Better Than Non-Drinkers'

TUESDAY, May 25 (HealthDay News) -- Moderate drinkers have a better health status than non-drinkers or heavy drinkers, but moderate alcohol consumption may be a marker, rather than a cause, of this status, according to research published May 19 in the European Journal of Clinical Nutrition.

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Poor Antiplatelet Response Not Fully Explained by Gene

TUESDAY, May 25 (HealthDay News) -- While antiplatelet drug response is clearly linked to the CYP2C19*2 polymorphism, the gene's presence does not explain most instances of poor antiplatelet response, even with other clinical factors taken into account, according to research published in the June 1 issue of the Journal of the American College of Cardiology.

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Frequent Doctor Visits Benefit Hypertensive Diabetes Patients

MONDAY, May 24 (HealthDay News) -- In hypertensive patients with diabetes, shorter intervals between encounters with physicians are associated with a faster decrease in blood pressure and earlier blood pressure normalization -- particularly intervals shorter than those currently recommended, according to a study published online May 24 in Hypertension.

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β-Blockers May Be Beneficial in Treating COPD

MONDAY, May 24 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) patients taking β-blockers may have a decreased risk of exacerbations, as well as a decreased mortality risk, according to research published in the May 24 issue of the Archives of Internal Medicine.

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Sugar-Sweetened Beverages May Affect Blood Pressure

MONDAY, May 24 (HealthDay News) -- Reducing consumption of sugar-sweetened beverages (SSBs) has a significant association with decreased blood pressure, according to research published online May 24 in Circulation.

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Statins Have Wide Range of Unintended Adverse Effects

FRIDAY, May 21 (HealthDay News) -- Statins appear to have no significant association with a large number of diseases, but they may have a wide range of unintended adverse effects, according to data published in the May 20 online edition of the BMJ.

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Stroke Incidence Falls in Cincinnati/Northern Kentucky

FRIDAY, May 21 (HealthDay News) -- The incidence of stroke decreased significantly among whites, but not blacks, in the Greater Cincinnati/Northern Kentucky area from 1999 to 2005, according to research published online May 20 in Stroke.

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Novel Stent Appears Effective in Coronary Artery Stenosis

THURSDAY, May 20 (HealthDay News) -- At one year, the novel thin-strut platinum chromium alloy TAXUS Element paclitaxel-eluting stent appears comparable to the TAXUS Express stent in treating coronary artery stenoses, according to research published in the July 20 issue of the Journal of the American College of Cardiology.

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Long-Term Aneursym Repair Survival Rates Similar

WEDNESDAY, May 19 (HealthDay News) -- Survival rates are similar six years after open or endovascular repair of abdominal aortic aneurysms, though secondary interventions are more common after endovascular treatment, according to research published in the May 20 New England Journal of Medicine.

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With Intermediate Risk of CAD, CTCA Valuable First Test

WEDNESDAY, May 19 (HealthDay News) -- As a tool for predicting the need for invasive coronary angiography (ICA), computed tomography coronary angiography (CTCA) appears to be most useful for patients at intermediate risk of coronary artery disease and may be more useful than stress testing in that population, according to research published May 18 in the Annals of Internal Medicine.

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Cerebral Vasoreactivity Related to Gait, Possibly Falls, in Elderly

TUESDAY, May 18 (HealthDay News) -- Impaired regulation of cerebral blood flow is associated with slowed gait and may be related to increased falls in the elderly, according to research published in the May 18 issue of the journal Neurology.

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Racial Disparities Reduced in Quality Monitoring Program

TUESDAY, May 18 (HealthDay News) -- Hospitals enrolled in a national quality monitoring and improvement program showed improvements in adherence to evidence-based guidelines for acute myocardial infarction (AMI), as well as reductions or elimination of racial/ethnic care disparities, according to research published May 17 in the journal Circulation.

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A Few Preventive Health Services Could Save Many Lives

MONDAY, May 17 (HealthDay News) -- Increased use of a few proven clinical preventive services, especially those aimed at reducing cardiovascular disease, could result in substantial improvements in health on a population-wide level, according to a study published online May 4 in the American Journal of Preventive Medicine.

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Earliest Receipt of Alteplase Benefits Stroke Outcomes Most

FRIDAY, May 14 (HealthDay News) -- The thrombolytic drug alteplase should be given as soon as possible after a stroke, as the odds of a favorable outcome decrease as the time to treatment increases, according to a pooled analysis published online May 15 in The Lancet.

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Many General Internists Leave Field by Mid-Career

FRIDAY, May 14 (HealthDay News) -- Roughly one out of six general internists are leaving internal medicine by mid-career, a substantially higher proportion compared to internal medicine subspecialists, according to survey results published April 29 in the Journal of General Internal Medicine.

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Stroke Sign Awareness Doesn't Translate to Calling 911

FRIDAY, May 14 (HealthDay News) -- Most adults cannot correctly identify stroke warning signs, and even those who can may not respond to them by calling 911, according to research published online May 13 in Stroke.

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Steps Per Day Linked to Metabolic Syndrome Prevalence

THURSDAY, May 13 (HealthDay News) -- Although public health recommendations have tended to focus on moderate-to-vigorous physical activity, an active lifestyle as measured by steps per day is associated with a reduced prevalence of both metabolic syndrome (MetS) and its cardiovascular disease (CVD) risk factors, according to research published online May 4 in the American Journal of Preventive Medicine.

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Long Work Hours May Adversely Affect Heart Health

THURSDAY, May 13 (HealthDay News) -- Working overtime could be bad for heart health, as it is associated with an increased risk for coronary heart disease (CHD), according to research published online May 11 in the European Heart Journal.

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New Implantable Cardioverter-Defibrillator Tested Effectively

WEDNESDAY, May 12 (HealthDay News) -- A new type of implantable cardioverter-defibrillator (ICD) with leads that can be implanted subcutaneously, rather than transvenously as with conventional ICDs, has successfully detected and converted ventricular fibrillation in a series of evaluation trials, according to a report published online May 12 in the New England Journal of Medicine.

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New FDA Program Targets Misleading Drug Advertising

WEDNESDAY, May 12 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new program to educate health care providers regarding their role in making certain that advertisements and promotions for prescription drugs are truthful and not misleading.

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Improved Risk Factors Lower Rate of CHD Deaths in Ontario

TUESDAY, May 11 (HealthDay News) -- In Ontario, Canada, the 35 percent decrease in the rate of deaths from coronary heart disease (CHD) seen between 1994 and 2005 is attributable to better medical and surgical treatments and improvements in traditional CHD risk factors such as total cholesterol levels and systolic blood pressure, according to a study in the May 12 Journal of the American Medical Association.

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Fibrates Found to Reduce Risk of Cardiovascular Events

TUESDAY, May 11 (HealthDay News) -- Fibrates can reduce the risk of cardiovascular events, mostly by preventing coronary events, and might have a role in individuals at high risk of these events and in individuals who have combined dyslipidemia, according to research published online May 11 in The Lancet.

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COPD Exacerbations May Raise Risk of Cardiovascular Events

TUESDAY, May 11 (HealthDay News) -- Exacerbations of chronic obstructive pulmonary disease (COPD) appear to increase the risk of myocardial infarction (MI) and stroke, according to research published in the May issue of Chest.

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D-Dimer May Be Marker for Adverse Events in A-Fib Patients

TUESDAY, May 11 (HealthDay News) -- During anticoagulation therapy for atrial fibrillation, D-dimer values may be useful in prediction of thromboembolic and cardiovascular events, according to a study in the May 18 issue of the Journal of the American College of Cardiology.

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N-Acetylcysteine Does Not Improve Angioplasty Outcomes

TUESDAY, May 11 (HealthDay News) -- N-acetylcysteine reduces oxidative stress but adds no other clinical benefit in ST-segment elevation myocardial infarction (STEMI) patients undergoing angioplasty, according to a study published in the May 18 issue of the Journal of the American College of Cardiology.

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Dizziness in the Elderly Often Due to Cardiovascular Disease

TUESDAY, May 11 (HealthDay News) -- In over half of elderly patients seen in primary care with a complaint of dizziness, cardiovascular disease is a contributing factor, and an adverse drug effect is a contributing factor in about one-fourth of patients, according to research published in the May 10 issue of the Annals of Family Medicine.

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Benefits Found Lacking for High-Dose Proton Pump Inhibitors

TUESDAY, May 11 (HealthDay News) -- Treatment with high doses of proton pump inhibitors (PPIs) is not associated with reduced rates of rebleeding, surgical intervention, or death in patients with bleeding peptic ulcers compared to non-high-dose PPI treatment, according to a meta-analysis published in the May 10 issue of the Archives of Internal Medicine alongside several other studies that explore the side effects associated with PPIs.

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Higher Nut Consumption May Improve Serum Cholesterol

MONDAY, May 10 (HealthDay News) -- Higher nut consumption is associated with lower serum cholesterol levels, especially among individuals with higher baseline low-density lipoprotein (LDL) cholesterol or lower body mass index, according to research published in the May 10 issue of the Archives of Internal Medicine.

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In Women With Diabetes, More Bran Tied to Lower Mortality

MONDAY, May 10 (HealthDay News) -- Increasing dietary whole grains, especially the bran component, is linked to decreased all-cause and cardiovascular disease-specific mortality in women with type 2 diabetes, according to a study published online May 10 in Circulation.

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AHA Cites New Evidence for Air Pollution's Role in Heart Events

MONDAY, May 10 (HealthDay News) -- Exposure to particulate matter (PM) less than 2.5 µm in diameter (PM2.5) has a causal role in cardiovascular morbidity and mortality, even if the exposure is not long term, and it is a modifiable risk factor, according to an update to an American Heart Association scientific statement published online May 10 in Circulation.

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Fluctuating Blood Pressure May Increase Risk of CVD in Elderly

MONDAY, May 10 (HealthDay News) -- High blood pressure (BP) and greater BP fluctuations are associated with an increased risk for cerebrovascular disease in older adults, according to research published in the May issue of the Archives of Neurology.

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High-Pressure Jobs Tied to Heart Disease Risk in Women

FRIDAY, May 7 (HealthDay News) -- Women in a high-pressure work environment have an increased risk of developing ischemic heart disease, according to research published in the May issue of Occupational and Environmental Medicine.

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Genetics Link Elevated Triglycerides to CHD Risk

FRIDAY, May 7 (HealthDay News) -- New genetic findings support the notion that elevated triglyceride levels have a causal association with coronary heart disease, according to a study in the May 8 issue of The Lancet.

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Microalbuminuria Can Predict Complications in Hypertension

FRIDAY, May 7 (HealthDay News) -- Microalbuminuria independently predicts higher risk of renal and cardiovascular complications in patients with primary hypertension but without diabetes, according to research published online April 29 in the Clinical Journal of the American Society of Nephrology.

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Incomplete Revascularization Linked to Higher Risk of Death

FRIDAY, May 7 (HealthDay News) -- Patients with significant coronary artery disease (CAD) who are not amenable to traditional revascularization have a risk of three-year mortality that is significantly higher than that of patients who undergo complete revascularization, according to a study published in the May 1 issue of Catheterization & Cardiovascular Interventions.

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Long-Term Effects Similar With CABG, Stents in LMCA Disease

THURSDAY, May 6 (HealthDay News) -- The rate of long-term adverse outcomes is similar in patients with unprotected left main coronary artery (LMCA) disease who undergo stenting or coronary artery bypass grafting (CABG), although those who undergo stenting have higher rates of target vessel revascularization, according to research published online May 5 in the Journal of the American College of Cardiology.

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High Resting Heart Rate Predicts Major Cardio Events

THURSDAY, May 6 (HealthDay News) -- In patients with stable coronary heart disease (CHD), a high resting heart rate is associated with an increase in major cardiovascular events, and the risk goes up as resting heart rate increases, according to research published in the April 1 issue of the American Journal of Cardiology.

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Everolimus-Eluting Superior to Paclitaxel-Eluting Stent

WEDNESDAY, May 5 (HealthDay News) -- Coronary everolimus-eluting stents result in superior clinical outcomes compared with paclitaxel-eluting stents, and reduced rates of target-lesion failure at one year seen with everolimus-eluting stents are consistent in all patients except those with diabetes, according to research published in the May 6 issue of the New England Journal of Medicine.

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Stent Type Does Not Affect Non-Cardiac Surgery Events

WEDNESDAY, May 5 (HealthDay News) -- Patients who undergo non-cardiac surgery after receiving a stent, especially within 42 days, are at increased risk for complications including death -- particularly after an acute coronary syndrome -- but the type of stent used is not an influencing factor, according to research published online May 4 in Circulation: Cardiovascular Interventions.

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China Bound for Cardiovascular Disease Epidemic

WEDNESDAY, May 5 (HealthDay News) -- The inevitable growth and aging of China's population will increase its rate of cardiovascular disease (CVD) by more than 50 percent in the next 20 years, but reducing or eliminating individual risk trends could help counteract the expected epidemic, according to research published online May 4 in Circulation: Cardiovascular Quality and Outcomes.

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Prognosis Varies Per Glycemic Index Pre-Revascularization

WEDNESDAY, May 5 (HealthDay News) -- Having a low -- but not too low -- glycemic index prior to surgery is optimal for best cardiovascular outcomes after coronary revascularization in patients with type 2 diabetes mellitus (DM), according to a study in the April 1 issue of the American Journal of Cardiology.

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Early Heart Failure Follow-Up Tied to Lower Readmission Rate

TUESDAY, May 4 (HealthDay News) -- Patients who are hospitalized for heart failure are unlikely to have early follow-up after discharge, but those who are discharged from hospitals that have a higher rate of following up within one week have a lower risk of being readmitted within 30 days, according to a study published in the May 5 issue of the Journal of the American Medical Association.

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Pneumococcal Vaccine Not Found to Reduce Heart Risks

TUESDAY, May 4 (HealthDay News) -- In older men, receipt of pneumococcal vaccine is not linked to a reduced risk of acute myocardial infarction (MI) and stroke, according to a study in the May 5 issue of the Journal of the American Medical Association.

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Kidney Disease Therapy May Increase Cardiovascular Risks

TUESDAY, May 4 (HealthDay News) -- For patients with chronic kidney disease (CKD), therapy with erythropoiesis-stimulating agents (ESA) that target higher levels of hemoglobin increases the risk of stroke, hypertension and thrombosis, according to a meta-analysis published online May 3 in the Annals of Internal Medicine.

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Biomarker Measurement Has Mixed Predictive Value

TUESDAY, May 4 (HealthDay News) -- Biomarker measurement may result in only modest improvement in coronary heart disease risk prediction in postmenopausal women, but inflammatory biomarkers are associated with heart failure risk in older adults, and measurement may improve heart failure risk stratification, according to two studies published in the May 11 issue of the Journal of the American College of Cardiology.

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Most People Don't Know Which Hospitals Are Stroke-Certified

TUESDAY, May 4 (HealthDay News) -- Despite believing that it is important to know where to get specialty stroke care, most Americans do not know which hospitals in their area are considered stroke-certified, according to the results of a survey released by the American Stroke Association on May 3.

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Pediatricians May Not Recognize High Blood Pressure

TUESDAY, May 4 (HealthDay News) -- At some pediatric practices, many cases of elevated blood pressure go unrecognized, and the most important factors associated with under-recognition are an absence of cardiovascular disease risk factors such as obviously elevated blood pressure, obesity, and family history of cardiovascular disease, according to a study published online May 3 in Pediatrics.

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Common Heart Defect Linked With Brain Aneurysms

MONDAY, May 3 (HealthDay News) -- People with a bicuspid aortic valve (BAV), a common heart defect, may be at higher risk for brain aneurysms, according to research published in the May 4 issue of Neurology.

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